Part 2: Abstracts From the NCCN 18th Annual Conference: Advancing the Standard of Cancer Care™
Authors: Kelly Bugos, Oxana Palesh, Kavitha Ramchandran, Kathryn Bailey, Blake Herring, Julie Kuznetsov, Douglas Blayney, Christopher Gayer, Joanne Buzaglo, Melissa Miller, Anne Morris, Victoria Kennedy, Mitch Golant, Marc Matsui, F Stewart, William Levy, Andrew Van Osdol, Jeffrey Landercasper, Jeremiah Andersen, Richard Ellis, Erin Gensch, Jeanne Johnson, Brooke De Maiffe, Kristen Marcou, Mohammed Al-Hamadani, Choua Vang, Norma Vinger, William Tew, Heidi Yulico, Arti Hurria, Howard Thaler, Oana Orodel, Dennis Chi, Ginger Gardner, Jason Konner, Carol Aghajanian, Stuart Lichtman, Beatriz Korc- Grodzicki, Reshma Jagsi, Grace Huang, Kent Griffith, Brian Zikmund- Fisher, Nancy Janz, Jennifer Griggs, Steven Katz, Sarah Hawley, Nadine Mccleary, Jeffrey Meyerhardt, Erin Green, Greg Yothers, Aimery De Gramont, Eric Cutsem, Michael O'connell, Christopher Twelves, Leonard Saltz, Daniel Haller, Daniel Sargent
Journal: Journal of the National Comprehensive Cancer Network (2013)

Background: Stanford Cancer Institute's goal to integrate NCCN standards of care for distress management into routine practice started with a multidisciplinary distress screen committee.The committee selected the PROMIS Global Health (GH) patient-reported outcomes measurement information system to recognize, monitor, document and address psychosocial health at all stages of cancer illness.PROMIS GH was tested in the Stanford Women's Cancer Center, a center for women with breast and gynecologic cancer.Method: PROMIS GH, developed and funded by the NIH, consists of 10 items to measure quality of life and mental and physical health on a Likert-type scale.The questionnaire consisted of this instrument along with the question "Would you like help with these issues?"The paper form was added to the routine check-in process during September 2012.A medical assistant screened all responses.Any response of "fair to poor" or "often to always" was assessed by a nurse coordinator and discussed with the medical team, and relevant psychosocial service referrals, including palliative care, were offered.Results: A total of 1350 patients seen in 19 clinic days received the questionnaire.A convenience sample of 304 questionnaires showed a high acceptability rate: 96% were fully complete.Patient ratings of mental health, including mood and ability to think, were "excellent" (18%), "very good" (26%), "good" (33%), "fair" (20%), and "poor" (3%).Patient ratings of emotional problems, such as feeling anxious, depressed, or irritable, were "never" (11%), "rarely" (29%), "sometimes" (39%), "often" (17%), and "always" (3%).These requests were for help (12%), among which were for management of distress (30%), pain (30%), physical issues (16%), sleep disturbance (8%), fatigue (5%), cognitive changes (3%), and a general request for help (8%).Clinic staff said the questionnaire was valuable in "taking better care of the patient."Conclusions: PROMIS GH was well accepted by patients and staff as a screen for emotional distress during this month-long pilot project.Including the questionnaire in the check-in process enabled universal administration.The authors were successful in routinely screening for distress in female patients with cancer using a validated instrument in busy clinics with existing personnel.Future plans include adding a spiritual question, adding the questionnaire to the electronic medical record, and expanding its use to the entire Stanford Cancer Institute.